PERMFILE44409

• Permit No: M1991078
• IBM Index Class Name: Permit File
• Doc Date: 1/2/1992
• Doc Name: LIMITED IMPACT OPERATION 110[2] RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

-2-

9. Corresporidence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Ind~iviwal's PJame:
Company Name: xiowA coUrrTx
Street: aox 591
City: EARS, CO 81036
State: Zip Code:
Area Code: 719 Telephone: 4'+8-SRin
PERMITTIIJG CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name: KzoWn CourrTY
Street: Box 591
City: EARS CO 81036
State: Zip Code:
Area Code: 719 Telephone: 438-581
INSPECTION CONTACT
Individual's Name: sAr1E
Company Name:
Street:
City:
State: Zip Code:
Area Code: ~ Telephone: _ __ ________ ____
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: uA
Street:
City:
State
Area Code: Telephone:
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: nrn
Str~aet:
City:
State:
Zip Code:
Area Code: Telephone: